Shoulder Special Tests Flashcards
What are three tests for shoulder dislocation?
- Apprehension Test for anterior shoulder dislocation
- Apprehension Test for posterior shoulder dislocation
- Sulcus Sign
How is the Apprehension test for posterior shoulder dislocation performed?
Patient in supine, arm in 90 degrees of flexion and medial rotation. Therapist applies a posterior forces through the long axis of the humerus
What are the 3 possible grades with the sulcus sign?
1+: <1 cm
2+: 1-2 cm
3+: >2cm
What are 3 tests for biceps tendon pathology?
- Ludington’s test
- Speed’s Test
- Yergason’s Test
How is Ludington’s test performed and what is positive?
Patient is asked to clasp hands behind head with fingers interlocked. the patient is ten asked to alternately contract and relax the biceps muscle.
Positive: absence of movement in the biceps tendon may indicate a rupture
How is Speed’s Test performed and what is a positive?
Elbow is extended and forearm supinated, place one hand over the bicipital groove and one hand on the volar surface of the forearm. Resist flexion
Positive: pain or tendersness over bicipital groove whihc may indicate bicipital tendonitis
How is Yergason’s test performed and what is a positive?
Patient sitting with 90 degrees of elbow flexion and forearm pronated. Humerus is stabilized against the patient;s thorax. Therapist places one hand on the patients forearm and the other on the bicipital groove. The patient is directed to actively supinate and laterally rotated against resistance
Positive: pain or tenderness over bicipital groove which may be indicative of a bicipital tendonitis.
What are 8 Rotator Cuff Pathology/Impingement tests?
- Drop Arm Test
- Hawkins-Kennedy Impingement Test
- Infraspinatus Test
- Lateral Rotation Lag Sign
- Lift off sign (medial rotation lag sign)
- Neer impingment test
- Supine impingement test
- Supraspinatus test
What does a positive of a Hawkin’s kennedy indicate?
impingement of supraspinatus tendon
How is the infraspinatus test performed? whats positive and what does it mean?
Patient stands with their elbow flexed to 90 and the shoulder in 45 degrees of internal rotation, the patient resists internal rotation force on forearm.
ARM AT SIDE, BASICALLY ER MMT!
Pain or weakness indicates the presence of an infraspinatus strain/tear
What does a positive on the lateral rotation lag sign indicate?
infraspinatus and/or supraspinatus pathology
What does a positive on a lift off sign test indicate?
subscapularis lesion
What does a positive on the Neer impingement test indicate?
potential shoulder impingement of the supraspiantus tendon. THINK ABOUT VIDEO FROM CLASS AND HOW IT GETS IMPINGED HIGH UP IN ROM
How is the Supine Impingement Test performed? Positive? What does it mean?
ELBOW IS STRAIGHT
Patient is supine with their arm fully flexed, externally rotated, and adducted to head. The therapist then internally rotates the shoulder
Positive: patient experiences a significant increase in pain with internal rotation
Indicates: impingment
How is the supraspinatus test performed? Positive? What does it mean?
BASICALLY EMPTY CAN TEST!!!!!!!
Pt in 90 degrees of abdcution followed by 30 degrees of horizontal adduction (scap plane) with the thumb pointed down (pronated arm)
The therapist resists pts abductoin
Positive: weakness or pain
Indicating Tear of supraspinatus tendon, impingement, or suprascapular nerve involvement
What are 5 tests for thoracic outlet syndrome?
- Adsons manuever
- Allen Test
- Costoclavicular Syndrome Test
- Roos Test
- Wright Test (hyperabduction test)
How is Adson’s manuever performed?
therapist monitors radial pulse while patient rotates their head to face the test shoulder, extends their head while PT externally rotates adn extends the shoulder.
Positive is absent or diminished raidal pulse
ALLEN IS ALWAYS ROTATING HIS HEAD AWAY FROM THE THORACIC OUTLET BECAUSE HE DOENST LIKE IT. ADSON looks towards it because he wants to see you manuever it.
It’s Adson’s Manuever because you are MANUEVERING THE PATIENT
How is Allen’s test performed?
Test arm is in 90 degrees of abduction, external rotation, and elbow flexion. The patient is asked to roatate the head AWAY form the test shoulder while PT monitors raidal pulse.
ALLEN IS ALWAYS ROTATING HIS HEAD AWAY FROM THE THORACIC OUTLET BECAUSE HE DOENST LIKE IT. ADSON looks towards it because he wants to see you manuever it.
How is Costoclavicular Syndrome Test performed?
Patient in sitting. PT monitors raidal pulse and assists the patient to assume a military posture (puff up chest and draw shoulders down back).
A positive test is diminished pulse causes by compression of subclavian artery between first rib and clavicle
How is Roos Test performed?
Patient in sitting or standing with the arms at 90 degrees of abduction, external rotation , and elbow flexion. Pt opens and closes hands for 3 minutes.
Positive: inability to maintain test position, sensory loss or ischemic pain
How is a Wright Test (hyperabduction test) performed?
Patient in sitting or supine. PT moves pts arm overhead in frontal plane while monitoring patients radial pulse
–> hyperabduction, like over their head as much abduction as possible
Positive: indicates compression of the costoclavicular space
What is O’Brien’s Active Compression Test?
Patient stands with arms flexed 90 and adducted 10 degrees, arms internally rotated with thumb down. Patient resists downward force. Shoulder then laterally rotated, and force again applied.
The test is positive for a superior labral tear if the patient experiences pain when the shoulder is in internal rotation but has decreased pain with shoulder in external rotation. MAKE SURE PAIN NOT OVER AC JOINT THO
What is the Glenoid Labrum Tear Test (CLUNK TEST)?
Patient in supine, place one hand over posterior aspect of the patients humeral head while the other hand stabilizes the humerus proximal to the elbow. The therapist passively abducts and externally rotates the arm over the patients head and then proceeds to apply an anterior directed force to the humerus.
BASICALLY BRING THEM INTO PITCHING POSITION AND MOVE THEIR SHOULDER ANTERIOR - ORTHO EVAL PALS on Youtube
Positive: clunk or grinding sound that may indicate a glenoid labrum tear
What is the Jerk Test?
Patient is sitting with shoulder elevated to 90 degrees and internally rotated with the elbow bent. The PT axially compresses through the elbow while horizontally adducting the shoulder.
Positive: a sudden clunk or jerk as the humeral head subluxed posteriorly indicates posterior instability. A second clunk or jerk may be heard when the shoulder is returned to starting position as the humeral head reduces. CAN INDICATE POSTERIOR LABRAL LESION
What is Upper Limb Tension Test 1?
Shoulder depression, 110 degrees abduction, elbow extension, wrist extension, finger and thumb extension
Nerve: median nerve, anterior interosseous
What is Upper Limb Tension Test 2?
Shoulder depression, 10 degrees abduction, elbow extended, forearm supination, wrist extension, finger and thumb extension, shoulder external rotation
Nerve: median nerve, musculocutaneous nerve, axillary nerve
What is Upper Limb Tension Test 3?
Shoulder depression, 10 degrees abduction, elbow extension, forearm pronation , wrist flexion and ulnar deviation, finger and thumb flexion, shoulder internal rotation.
ULNAR DEVIATE SINCE GOING AWAY FROM SIDE OF NERVE
Learned to abduct last!
Nerve: radial nerve
What is Upper Limb Tension Test 4?
Shoulder depression, 90 degrees abduction of straight arm, elbow flexion, forearm pronation(or sup), wrist extension and radial deviation, finger and thumb extension, shoulder external rotation
RADIAL DEVIATE SINCE GOING AWAY FROM SIDE OF NERVE
Nerve: Ulnar nerve
